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Current Liabilities (Details) - USD ($)
$ in Thousands
Sep. 30, 2019
Dec. 31, 2018
Payables and Accruals [Abstract]    
Commercial rebates, fees and returns $ 127,138 $ 80,520
Professional, license, and other fees and expenses 18,964 23,242
Salaries, bonuses, and other compensation 17,498 22,482
Research and development expense 3,467 1,067
Interest expense 4,020 2,226
Restructuring expense 1,198 0
Total accrued expenses $ 172,285 $ 129,537